Senior Living BUSINESS

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1 Senior Living Living Business Page Volume 6, 3, Issue 61 Dec-Jan June BUSINESS Financial News, Growth Strategies, and Best Practices for Providers and Suppliers IN THIS ISSUE Not-For-Profit Vs. For-Profit CCRC Models For both models, most operations are similar; but financing approaches and market valuations can differ significantly. Also, separate business and mission income statements make sense for not-for-profits. See page 1 CCRC Pricing Strategies: Observations & Ideas Some providers are holding the line when it comes to pricing, and others are considering a rental option; but rolling back prices may be the smartest move. And perhaps providers should begin to think completely differently: How about free pricing? See page 1 Best Practices Q&A Marsha Greenfield The vice president of legislative affairs at LeadingAge talks about senior living advocacy and the importance of building relationships with elected officials. See page 2 Recent Financing Activity See page 4 New Energy Star Certification For Senior Care Facilities See page 6 The Acquisition Market See page 15 CCRC Pricing Strategies: Observations & Ideas And Did You Ever Consider Giving Away Your Product For Free? Providers understand that they can t simply apply a progressive increase to their pricing each year. Rather, they actively consider what the market will bear, including local real estate values, as their baseline. But it s a lack of willingness to take action that sometimes causes problems, according to Mary McMullin, President of New Life Management & Development in La Canada, California. People are slow to change their pricing, because they feel it diminishes their value, she said. But my question to them is: Is their product still strong enough to charge the premium price that it once commanded? McMullin strongly recommends re-pricing rolling prices back rather than offering short-term pricing incentives, although a lot of providers have recently been throwing incentives at the market to see what might stick. First of all, an incentive needs to be large offering a $2,000 or $5,000 discount won t make a difference to most buyers. And it must be meaningful relevant to what people in that area want. Do they want help with closing costs on the sale of their house? Do they want moving assistance? What will get people in the door faster? Most importantly, any incentive must be limited. It has to end at a date certain. Once the incentive has expired, one of the hardest things for sales teams to do because they don t want to give up a sale is to tell customers that they can t get the benefit anymore. But they must, she said. Otherwise, the incentive loses all meaning. Assess the competition When setting prices or re-pricing it s always important to assess your competition. Providers should break down and compare a competitor s price by square foot, of course, but then be sure to review the comparable amenities, the type of health-care contract(s) provided, and any recent renovations to the property. A community that provides full life care, for example, won t (and shouldn t) be in the same price range as one that offers fee-for-service health care. The entrance fee may be the same, but the monthly fee for a life-care community certainly should be higher. McMullin also advises providers to look at which types of units the competition is selling, as well as the quality of those units, to gauge what the market is willing to pay and for what type of unit. Then you can either adjust your price or decide that you won t; but at least you ll base your decision on knowledge. Too often I see providers simply compare entrance fees and decide they need to adjust their price, she said. But when they really look into it, they find that they have a different refund program or a different health-care contract or have recently renovated. You really have to compare each element.

2 Page 2 Senior Living Business Dec-Jan 2012 Senior Living Business ISSN#: Published monthly by: Irving Levin Associates, Inc /2 Main Avenue Norwalk, CT (203) Fax (203) info@seniorlivingbusiness.com Publisher Executive Editor Editor Advertising Eleanor B. Meredith Stephen M. Monroe Jane E. Zarem Karen H. Pujol EDITORIAL ADVISORY BOARD John Durso, Esq., Attorney at Law Ungaretti & Harris LLP Dan Gray, President Continuum Development Services, Inc. Marvin Mashner, President & CEO ACTS Retirement-Life Communities, Inc. Jim Moore, President Moore Diversified Services, Inc. T. Brian Pollard, Senior Managing Director Lancaster Pollard Paul F. Steinhoff Jr., Vice Chairman & CEO Greystone Communities, Inc. David C. Turner, President & CEO Masonic Health System of Massachusetts Annual Corporate Subscription Rate: $587 Includes Free Additional Copies Paid subscribers may request additional copies of Senior Living Business for staff or board members at no extra charge. Call Karen Pujol at (800) or your request, including the relevant address(es), to customerservice@levinassociates.com Irving Levin Associates, Inc. All rights reserved. Reproduction or quotation in whole or part without permission is forbidden. This publication is not a complete analysis of every material fact regarding any company, industry or security. Opinions expressed are subject to change without notice. Statements of fachave been obtained from sources considered reliable, but no representation is made as to their completeness or accuracy. This Firm or persons associated with it may at any time be long or short on any securities mentioned in the publication and may from time to time sell or buy such securities. This Firm or one of its affiliates may from time to time perform investment banking or other services for, or solicit investment banking or other business from, any company mentioned in this publication. POSTMASTER: Send address changes to Senior Living Business, 268-1/2 Main Avenue, Norwalk, CT Cost-of-vacancy calculator A cost-of-vacancy calculator can determine how much in monthly fees a provider is losing on vacant units. The loss will depend on the maturity of the community. Older communities may be losing monthly fees, which are their bread and butter. Newer communities may be foregoing entrance fees, because the price is too high or units need renovating and, as a result, stay empty month after month. In either case, real money is being lost. McMullin recently calculated the cost of vacancy for a client who was resistant to any pricing change. When her calculation proved that the organization s total loss in monthly fees on its current stock of vacancies amounted to more than a half-million dollars, she advised the client to bite the bullet and change the price structure. It s a brutal truth for a lot of communities, she said. Some providers have occupancy rates only in the 60-70% range. That, to me, is a stubborn acknowledgement that they re not willing to change their price no matter what but buyers are telling them what they re willing to pay and are not moving in. The cost-of-vacancy calculator is also an eye-opener from a renovation standpoint. Often, providers don t want to pay to renovate vacated units until they have a buyer lined up. But buyers want to see a finished product. They want it done, McMullin said. Entrance fees and refunds One of the biggest risks for seniors and perhaps their biggest fear is outliving their resources. The advantage of the entrance-fee model, particularly the Type A contract, is financial security. Increases in monthly fees roughly match inflation; and if residents live longer than expected and run out of money through no fault of their own, communities are very reluctant and unlikely in the case of not-forprofits to move them out. Not-for-profits certainly don t want the IRS to spotlight their tax-exempt status, and no community wants to invite negative public relations. We advise all of our clients to charge actuarially sound fees, said A. V. Powell, CEO of A.V. Powell & Associates, LLC in Atlanta. In other words, they demonstrate the lifetime costs for a given resident and charge fees that will produce enough operating capital to cover those costs over that lifetime. His clients typically include a 10% actuarial margin in their pricing and, because of that, actually increased their financial position and were able to weather declining occupancy despite the economic crunch. Among Powell s clients that offer multiple contract

3 Senior Living Business Page 3 options, the majority of new residents select the option with the lowest entrance fee if the relationship between nonrefundable and refundable entrance fees is priced to be actuarially correct. And by actuarially correctly priced, he means that the differential or spread between the entrance fee for the nonrefundable contract and that for a 90% or higher refundable contract is about 100%, or double, for the typical age-80 entrant. Only a handful of seniors and typically older seniors choose the refundable option when the spread is actuarially correct, according to Powell. Refundable contracts may offer a 50% or 25% refund, although the overwhelming majority of residents who choose a refundable entrance-fee model currently select the 90% or 95% refundable contract. The guaranteed return mitigates prospective resident concerns about depleting their estates. Getting a 50% refund usually isn t a deal breaker, although a 25% refund often is. The marketplace actually makes good actuarial decisions, according to Powell. People will choose the type of contract that s in their favor the majority of the time, he said. According to contractual agreements, the vast majority of refunds are payable upon resale of the unit although some communities offer a limited timeframe to assure buyers that the refund will, in fact, become part of their estate. Communities generally follow state law; however, a time limit for all or part of the refund applies only in certain states, such as Massachusetts. By the same token, a facility that is operating soundly and has adequate reserves even if it is having trouble filling up will often pay out the refund right away to avoid any negative perception. The problem for many providers, though, is that a high-refundable plan doesn t always provide enough capital to make the model work. Turnover is too fast and doesn t allow enough time for the entrance fee to appreciate sufficiently particularly at current rates of return. In addition, providers are investing the money in renovations. As a result, McMullin sees many communities returning to a prorated, nonrefundable, declining refund program. That may not be a bad thing. Often the entrance fee itself becomes significantly less 20-60% less, depending on the market and the lower price point of entry may actually open up the model to a broader audience. Converting entrance-fee to rental units Converting entrance-fee units to rental is often not feasible for providers that offer a high-refundable program, as those communities usually depend on entrance fees paid by new residents to provide the capital needed to pay refunds to vacating residents or their estates. A few communities, even before 2008, offered rental options on a trial or temporary basis; at the end of the trial or temporary period, renters either moved out or moved up to an entrance-fee contract. Every now and then, though, an older community will decide that converting to rental is the only way stay afloat and will get out of the entrance-fee model altogether. Depending on its amount of debt, the conversion can work; but the smaller, older communities that offered slidingscale entrance fees are the ones most likely to succeed. Although still more of an exception than a trend, older communities do seem to have more interest in converting some units to a rental program than they once did, according to McMullin, particularly in the case of smaller apartments with entrance fees that were out of reach for people interested in that amount of space. At the same time, people who want a large apartment at a fee they can afford won t rent the lowest cost apartment just to get into the community. They still want the space that they feel works for them. So the same prospect may not be willing to rent a smaller space, but the community may attract a different market that is willing to rent prospects that had previously ruled themselves out of the CCRC market because of the upfront capital payment. Rental units usually don t include health care access is on a space-available rather than a guaranteed basis. And renters don t participate in a resident benevolence fund; if they run out of assets, they re expected to move out. Also, monthly fees for a rental unit are significantly more perhaps $1,000 more than for an entrance-fee unit. Some communities again, older ones are also offering a rent-and-convert program, where people initially move in on a monthly rental program and within a defined time after their house sells or simply based on their experience at the community can convert to an entrancefee program and get a discount or some other favorable treatment. Horizon House in Seattle, for example, has a program where residents who lease certain apartments can convert to an entrance fee within the first year and get up to a $12,000 discount, according to McMullin. Basically, the provider is applying the $1,000 premium paid each month to the entrance fee, she explained. People like it. They can

4 Page 4 Senior Living Business Dec-Jan 2012 move in without putting up the capital. But then they feel strongly enough about the community that they do buy in. So far, Horizon House has converted 60% of the renters. A free pricing approach In a typical senior living organization, the traditional source of revenue is resident fees per unit/bed per month/day, but providers might well consider a variety of other opportunities to strengthen their bottom line and also improve occupancy. Scott Townsley, Principal at ThirdAge, a division of LarsonAllen, in Exton, Pennsylvania, encourages providers to think differently about revenue sources. He has suggested some approaches based on giving consumers something for free not as a gimmick, he cautioned, but as a market strategy. Given the deficit, cutbacks in Medicare and Medicaid, and pricing pressures brought on by the recession and the lagging housing market, drawing from new or different revenue sources becomes imperative. One example of his free approach is in the at-home service area, where volume is a tremendous driver and a combination of membership payments and fundraising bring them to a break-even point. Using telephone research, Third Age asked a targeted group of seniors if they were willing to pay a small amount of money to participate in a program that offered the coordination of care and services; 12% indicated they were very interested. When asked if they d pay $50 a year to enroll in such a program, the very interested group dropped to 10%. But when asked if they d be willing to enroll if it were free, the very interested percentage jumped to 20%. The response became really compelling about 40% when the somewhat interested group was added in. My Way, a program in Philadelphia that is structured on a free model, attracted 845 members within about 12 months of operation. Membership is free and similar to the Beacon Hill Village program in Boston members pay affordable, often discounted, rates for the services that they use. Charitable contributions from sponsors and others provided the start-up capital to launch the My Way program. Revenue flows from various programs. For any member organization sponsor or service provider, the volume of participation in programs or services can result in substantial ancillary revenue. A senior might pay $10 for a bus trip to the mall, Townsley suggested. If enough people go, the revenue can be more than necessary to cover the provider s cost. Senior living experienced a kind of perfect storm: aging physical plants, a changing consumer, and economic problems all happening at the same time. The industry didn t always have the most progressive product yet was facing a consumer looking for a progressive option. And because senior living is so tied up with real estate, change takes a long time. Then, frankly, organizations weren t well equipped to deal with the economic situation. They had always been full, even had waiting lists, and never felt the need to market although I believe you always need to market. Mary McMullin Other programs or services, where there s no additional cost to add a few people to a program, might be free to the user or carry a nominal fee. Or the provider may offer a free gift to attract paying customers to its programs. One senior living provider, for example, offered a free balance assessment to customers who enrolled in one of its wellness programs. Once you ve attracted people to your programs for a few years, and a time comes when they consider moving into a senior living community, then yours becomes the natural choice, he added. The more challenging application is applying a free approach to residential units. For illustration purposes only, Townsley calculated a plan for an organization with studio apartments that were consistently vacant over several years not always the same apartments but the same number of vacant ones. Under the free model, the provider wouldn t charge for the real estate no entrance fee or rent, per se but would charge for the services they use, the things they consume, and the items that they would have to pay by remaining at home (taxes, insurance, housekeeping, etc.). Rolling that into a package, his calculation resulted in 57% of the normal monthly fee. So by giving away the real estate but offering a service package at 57% of the normal monthly fee, the provider could generate about $185,000 a year for 13 units that otherwise would sit empty. That approach captures significant revenue that otherwise would be lost. Of course, residents paying full freight may raise an eyebrow at that type of deal; but the provider could draw the distinction that the offer is temporary (perhaps a year or two or while people try to sell a home), that the service package is limited to certain types of units (perhaps smaller or older ones), and that the residents don t have priority access to health care (assisted living or skilled nursing).

5 Senior Living Business Page 5 Furthermore, if the added revenue weren t coming in, the fee increase for current residents would have to be higher. The free real estate approach also allows the provider to put off renovations until the economy recovers and capital markets stabilize. Providers get too consumed with getting expenses in line and calculating fee increases, he observed. They should be thinking: Let s come about this really differently. Bottom line: Research indicates that the word free is still riveting to consumers. And by adopting some type of free approach, providers can begin to build relationships with prospective residents and create a connection between them and the community. It gets them inside, said Townsley.